Summary

This Amsterdam study followed up a 1995 paper in Nature on the BSTc, a tiny area deep in the brain. Instead of measuring its size, the researchers counted one type of its nerve cells in 42 brains donated after death. Men had about 71% more of these cells than women, whatever their sexual orientation. Six trans women had counts in the female range, and one trans man had a count in the male range. The authors said this points to a biological basis for gender identity. But the six trans women were the same people studied in 1995, all treated with estrogen and testosterone blockers and mostly castrated. So this is the same brains looked at another way, not a new test. The claim that hormones played no part rests on a few single cases. The same team later found the male-female difference in this area appears only in adulthood. No independent team has repeated the finding.

Key findings

• O estudo contou um tipo de célula nervosa em uma minúscula área do cérebro chamada BSTc em 42 cérebros doados ao Banco de Cérebros dos Países Baixos após a morte.
• Os cérebros de comparação vieram de 9 homens presumidamente heterossexuais, 9 homens gays, 10 mulheres presumidamente heterossexuais e várias pessoas com distúrbios dos hormônios sexuais.
• Os homens heterossexuais tinham cerca de 33.000 dessas células, cerca de 71% mais do que as mulheres; os homens gays estavam na faixa masculina.
• As seis mulheres trans tinham em média cerca de 20.000 células, perto das mulheres; não houve diferença mensurável entre elas e as mulheres.
• Um homem trans tinha uma contagem na faixa masculina, e um homem de 84 anos não tratado, com fortes sentimentos de ser do outro sexo, tinha uma contagem na faixa feminina.
• Para argumentar que os hormônios não causaram o resultado, os autores apontaram mulheres trans que haviam parado o estrogênio 3 a 15 meses antes da morte e um homem de 31 anos com um tumor produtor de estrogênio cuja contagem estava na faixa masculina.
• Os cérebros das mulheres trans eram os mesmos seis estudados por Zhou e outros em 1995, de modo que isso examina de novo esses casos em vez de repetir o achado em pessoas novas.

Abstract

Transsexuals experience themselves as being of the opposite sex, despite having the biological characteristics of one sex. A crucial question resulting from a previous brain study in male-to-female transsexuals was whether the reported difference according to gender identity in the central part of the bed nucleus of the stria terminalis (BSTc) was based on a neuronal difference in the BSTc itself or just a reflection of a difference in vasoactive intestinal polypeptide innervation from the amygdala, which was used as a marker. Therefore, we determined in 42 subjects the number of somatostatin-expressing neurons in the BSTc in relation to sex, sexual orientation, gender identity, and past or present hormonal status. Regardless of sexual orientation, men had almost twice as many somatostatin neurons as women (P < 0.006). The number of neurons in the BSTc of male-to-female transsexuals was similar to that of the females (P = 0.83). In contrast, the neuron number of a female-to-male transsexual was found to be in the male range. Hormone treatment or sex hormone level variations in adulthood did not seem to have influenced BSTc neuron numbers. The present findings of somatostatin neuronal sex differences in the BSTc and its sex reversal in the transsexual brain clearly support the paradigm that in transsexuals sexual differentiation of the brain and genitals may go into opposite directions and point to a neurobiological basis of gender identity disorder.

Conclusion

The authors concluded that the somatostatin neuronal sex difference in the BSTc, and its sex reversal in the transsexual brain, clearly support the paradigm that in transsexuals sexual differentiation of the brain and genitals may go in opposite directions, and point to a neurobiological basis of gender identity disorder. They argued that hormone treatment or variations in adult sex-hormone levels did not seem to have influenced BSTc neuron numbers, citing individual transsexuals who had stopped estrogen before death and non-transsexual patients with hormone disorders.